How much rates vary
Facilitymedian $95 · 10th to 90th $40 to $178Professionalmedian $38 · 10th to 90th $31 to $43
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $38.02 Median $52.48 Typical High $87.10 | Facility | None | $38.02 | $52.48 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | None | $38.02 | $38.02 | $38.90 |
BCBS Texas Setting Facility Modifier None Typical Low $43.65 Median $107.15 Typical High $186.21 | Facility | None | $43.65 | $107.15 | $186.21 |
BCBS Texas Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $72.44 Typical High $123.03 | Facility | None | $38.02 | $72.44 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Lucent Health Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $74.13 | Professional | None | $42.66 | $52.48 | $74.13 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $48.98 Typical High $104.71 | Facility | None | $39.81 | $48.98 | $104.71 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $40.74 | Professional | None | $39.81 | $39.81 | $40.74 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $42.66 | Professional | None | $37.15 | $37.15 | $42.66 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $147.91 | Professional | None | $42.66 | $70.79 | $147.91 |
Providence Setting Facility Modifier None Typical Low $38.02 Median $54.95 Typical High $323.59 | Facility | None | $38.02 | $54.95 | $323.59 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $44.67 | Professional | None | $39.81 | $41.69 | $44.67 |
Wellpoint Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
16 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $19.05 Median $27.54 Typical High $43.65 | Facility | 52 · Reduced service | $19.05 | $27.54 | $43.65 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $11.22 Typical High $17.38 | Facility | 53 · Discontinued | $7.59 | $11.22 | $17.38 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.75 Median $8.32 Typical High $12.88 | Facility | 55 · Aftercare only | $5.75 | $8.32 | $12.88 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.62 Typical High $8.71 | Facility | 56 · Pre-op care only | $3.80 | $5.62 | $8.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.05 Typical High $19.50 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.89 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.89 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $19.95 Median $23.99 Typical High $47.86 | Facility | 52 · Reduced service | $19.95 | $23.99 | $47.86 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $7.94 Median $9.55 Typical High $19.05 | Facility | 53 · Discontinued | $7.94 | $9.55 | $19.05 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $14.45 | Facility | 55 · Aftercare only | $6.03 | $7.24 | $14.45 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.79 Typical High $9.55 | Facility | 56 · Pre-op care only | $3.98 | $4.79 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $19.95 Typical High $20.42 | Professional | 52 · Reduced service | $19.95 | $19.95 | $20.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.07 |
Where Texas sits
The same service costs 1.6 times more in Alaska than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 49th of 51
$38.02
AK $60.26SC $38.02
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.